A longitudinal examination of leisure time physical activity following amputation in England

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Objectives:There is a significant body of research on leisure time physical activity (LTPA) among people with physical disabilities. Yet, while this data set has been informative in identifying the social-relational factors that affect LTPA across disability groups, there is now a demand for context- and population-specific studies to provide a more nuanced understanding to better inform decision-makers and service-providers. This original study is the first to examine the barriers, facilitators, and benefits of LTPA among people with an amputation in England.Methods:Multi-method, longitudinal research design (from April 2014 to May 2016). Participants were recruited using maximum-variation and criterion-based purposeful sampling. Data collection included two focus groups (>4hrs), fieldwork observations (>225hrs), and 44 formal interviews (>50hrs). Practical strategies used to support or evidence the study's quality in terms of its credibility, rigour, generalizability, and significance included author self-reflexivity, member reflections from participants, and external reflections with key stakeholders before seeking publication. This large qualitative dataset was rigorously analysed using inductive thematic analysis.Results:Ten themes were identified: personal wellbeing, social wellbeing, physical wellbeing, inspiration, self-presentation, experience of LTPA, knowledge of LTPA, environment, organisational functioning, and miscellaneous.Conclusions:This article makes a novel and significant contribution to research by revealing the dynamic and relational nature of barriers, facilitators, and benefits. Practical implications for LTPA policies and practices are considered through a social ecological lens (i.e., intrapersonal, interpersonal, institutional, community, and policy).HighlightsAn original and rigorous examination of leisure time physical activity (LTPA) among people with an amputation in England.Factors implacting LTPA in England are dynamic, fluid, and relational.Findings provide a rigorous foundation for a ‘bottom up’ approach for LTPA promotion (NHS England, 2014).Practical implications are considered at an intrapersonal, interpersonal, insitutional, community, and policy level.

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